Increased risk of gestational diabetes in women with IBD: pregnancy outcomes for women with IBD from a multidisciplinary clinic at a tertiary centre

Objective Inflammatory bowel disease (IBD) can have an impact on maternal and neonatal outcomes. This study reports the pregnancy outcomes, rates of gestational diabetes (GDM) and hypertensive disorders of pregnancy (HOP) in women with IBD cared for in a dedicated IBD-maternal fetal medicine (IBD-MFM) clinic compared with a group of age-matched controls. Design/methods A retrospective cohort study comparing the outcomes of 146 patients with IBD cared for in a dedicated IBD-MFM clinic and 292 consecutive, age-matched controls without IBD. We analysed the associations between IBD and maternal/neonatal outcomes. ORs were calculated and a multivariate logistic regression model was used to correct for confounding variables. Results A diagnosis of IBD was significantly associated with the development of GDM compared with controls (OR 1.86, CI 1.05 to 3.29, p=0.033). This was independent of confounding variables such as corticosteroid exposure. A diagnosis of IBD was associated with a significantly lower rate of HOP compared with controls (OR 0.04, CI 0.01 to 0.37, p=0.004). 45.2% of patients with IBD had active disease during pregnancy which significantly increased the risk of small for gestational age (SGA) (OR 5.16, CI 1.35 to 19.68, p=0.02) but not low birth weight (LBW), preterm birth or risk of neonatal intensive care admissions (NICU). Biologic use was not associated with adverse maternal or neonatal outcomes. Conclusions A diagnosis of IBD is associated with a significant increase in the risk of GDM and is independent of confounding variables. Active disease in pregnancy was significantly associated with SGA but not LBW, preterm birth or NICU admissions.